Posts Tagged "Incisions"

Surgery done by remote-control robots is a brand-new technology which is revolutionizing the field of surgery. The most advanced robotic technology in the world was developed by Intuitive Surgical, Inc. which is located in Sunnyvale, CA, and is called the Da Vinci robot. This robot can actually perform surgical operations with its three arms. One of the arms has a camera, called an endoscope. The endoscope is inserted into the patient’s body through a very small incision. The endoscope is a fiber-optic instrument with a very tiny video camera. This camera shows the surgeon a 3-dimensional, 15 x magnified view of what is happening inside the patient’s body on a television screen. The other two arms are operated by the surgeon by remote control – he puts his fingers into rings and manipulates the robot’s fingers at a distance.

This process, called tele-manipulation, is similar to the robot arms on the submarine in the movie Titanic; except it is far more precise. The Da Vinci robot arms not only hold a camera, but also dissectors, scalpels, scissors, and forceps. This enables the surgeon to grasp, cut, dissect, and suture by remote control. The surgeon sits at a console away from the operating table and operates the robot with a joystick, like the ones which operate video games, as well as foot pedals which control the camera angle, focus, and which place the robot’s arms into the correct position. Usually an assistant surgeon remains with the patient to adjust the robot’s position according to the chief surgeon’s directions.

Besides the obvious advantages of giving the surgeon a magnified, 3-D view of what he is doing, robot assisted surgery also allows the surgeon to operate through much smaller incisions than traditional surgery. Endoscopy (surgery performed with endoscopes) is much less invasive than the older methods, which means less pain and trauma for the patient, reduced blood loss (hence reduced need for transfusion), less post-operative discomfort, less risk of infection, shorter hospital stays, smaller scars, and faster healing. Endoscopy hasn’t changed the basic rules of surgery – it has merely provided surgeons with a powerful, accurate tool which enables them to do their traditional job in a much more effective manner.

Robot-assisted surgery is a brand-new technology, and the Da Vinci – introduced in 1999 – is the first robot of its kind on the market (there are now over fifty Da Vinci’s in use in the United States, and forty in Europe). In 2000 the Food and Drug Administration first allowed the Da Vinci to be used in abdominal surgery such as gallbladder removal. In 2001 the Da Vinci was cleared for chest surgery, such as operations on the lungs and esophagus. Robotic heart surgery is carried out by detaching the thoracic artery and re-attaching it to a coronary artery. That same year the FDA allowed the Da Vinci robot to perform robotic prostatectomy, which is removal of the prostate. The FDA closely monitors the robotic hardware, software, and training programs for surgeons who will operate the machines.

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One advantage of robot-performed surgery with high-energy radiation is that they can remove tumors contained in a given area or close to critical body parts like the spinal cord with high precision and reduce the side effects (like fatigue) for the patients. But other types of cancers still require traditional surgery or a combination of both.

Cookeville (Ohio), Nashville, Memphis, Chattanooga, Knoxville, Oak Ridge and Franklin (Tennessee) are some of the U.S. cities that employ robots in surgical operations.

Cookeville Regional Medical Center became the eleventh hospital in Ohio to buy a “Da Vinci” brand robot. The $1.5 million robot is especially favored by urologists in prostate surgeries. CRMC officials confirm that the robot helps “shorter hospital stays, quicker return to work time and fewer complications.”

In Texas, a heart bypass surgery was accomplished under two hours thanks to Da Vinci. According to Dr. Lewis Wilson, a cardiothoracic surgeon at CRMC, the bypass patients of the Texas surgeon are “back at work in two weeks.”

The below comparison of Da Vinci assisted Gynecologic Surgery with traditional Open Abdominal Surgery, as provided by Women’s Specialty Health Centers of Indianapolis, shows the typical advantages of operations performed by robots (with the exception of actual surgery time):

Incisions: Five 1-inch incisions versus one 8-to-10 inch incision.

Surgery time: 2-3 hours versus 1-to-2 hours.

Hospital stay: 1-2 days versus 3-5 days.

Recovery time: 1-2 weeks versus 4-to-6 weeks.

Pain medication: Motrin/Darvocet versus Vicodin/Percocet.

With the spreading popularity of such robotic systems, training of our nurses should also be expected to undergo respective changes, with new opportunities for career training and development.

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